Study: Bias in software may miss lung issues in Black men

NEW YORK — Racial bias built into a common medical test for lung function is likely leading to fewer Black patients getting care for breathing problems, a study published Thursday suggests.

As many as 40% more Black male patients in the study might have been diagnosed with breathing problems if current diagnosis-assisting computer software was changed, the study said.

Doctors have long discussed the potential problems caused by race-based assumptions that are built into diagnostic software. This study, published in JAMA Network Open, offers one of the first realworld examples of how the issue may affect diagnosis and care for lung patients, said Dr. Darshali Vyas, a pulmonary care doctor at Massachusetts General Hospital.

The results are “exciting” to see published but it’s also “what we’d expect” from setting aside race-based calculations, said Vyas, who was an author of an influential 2020 New England Journal of Medicine article that cataloged examples of how race-based assumptions are used in making doctors’ decisions about patient care.

For centuries, some doctors and others have held beliefs that there are natural racial differences in health, including one that Black people’s lungs were innately worse than those of white people. That assumption ended up in modern guidelines and algorithms for assessing risk and deciding on further care. Test results were adjusted to account for — or “correct” for — a patient’s race or ethnicity.

The new study focused on a test to determine how much and how quickly a person can inhale and exhale.